Form DDAP-EFM-1304 Gambling Treatment Program Admission Form - Pennsylvania

What Is Form DDAP-EFM-1304?

This is a legal form that was released by the Pennsylvania Department of Drug and Alcohol Programs - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the Form DDAP-EFM-1304?
A: The Form DDAP-EFM-1304 is the Gambling Treatment Program Admission Form in Pennsylvania.

Q: What is the purpose of the form?
A: The form is used for admission into the Gambling Treatment Program in Pennsylvania.

Q: Who is required to fill out this form?
A: Individuals seeking admission into the Gambling Treatment Program in Pennsylvania are required to fill out this form.

Q: Is there a fee for submitting this form?
A: There is no fee for submitting this form.

Q: What information is required on this form?
A: The form requires personal information such as name, contact details, gambling history, and treatment preferences.

Q: What happens after I submit this form?
A: After submitting the form, your application will be reviewed, and you may be contacted for further information or to schedule an appointment for assessment.

Q: Is the information on this form kept confidential?
A: Yes, the information provided on this form is kept confidential and protected by relevant privacy laws.

Q: Can I withdraw my application after submitting this form?
A: Yes, you can withdraw your application at any time by contacting the Gambling Treatment Program.